Cholesterol-Lowering DietEn Español (Spanish Version)
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
A cholesterol test should be done after a 9- to12-hour fast. The results that you want to focus on are the total, LDL, and HDL levels.
- Total cholesterol—Your total cholesterol should be less than 200 milligrams per deciliter (mg/dL [11.1 mmol/L]). However, what is even more important is the breakdown of LDL and HDL cholesterol.
- LDL cholesterol—Also known as bad cholesterol, tends to build up along your arteries. LDL levels are increased by eating fats that are saturated or hydrogenated. This level should be less than 100 mg/dL (5.6 mmol/L).
- HDL cholesterol—Also known as good cholesterol. It actually carries bad cholesterol away from your arteries and may, therefore, help lower your risk of having a heart attack. This level should be 60 mg/dL (3.3 mmol/L) or above.
Diet is one of several factors that affect cholesterol levels. Other factors include heredity, age, sex, physical inactivity, and being overweight. The main dietary components that impact cholesterol levels are
Fat is an essential nutrient with many responsibilities, including transporting the fat soluble vitamins
, protecting vital organs, and providing a sense of fullness after meals. Fat can be broken down into four 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.
- Animal fats
that are saturated include: butter, lard, whole-milk dairy products, meat fat, and poultry skin
- Vegetable fats
that are saturated include: shortening, palm oil, coconut oil, and cocoa butter
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 10% of calories should come from saturated fat on a cholesterol-lowering diet. Trans fat intake should be as little as possible, ideally reduced to zero.
On an 1,800 calorie diet, this translates into less than 20 grams of saturated fat per day, leaving 40 grams to come from 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 consume no more than 200 milligrams of cholesterol a day.
Eating a diet high in soluble fiber can help lower your LDL cholesterol. There are two main types of
: 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 CategoryFoods RecommendedFoods to AvoidGrains
- Whole grain breads and cereals, pasta, rice, potatoes, low-fat crackers
- High-fat baked goods like muffins, donuts, and pastries
Crackers made with
- All; choose whole fruit over juice for added fiber
- Vegetables with added fat or sauce
- Nonfat or low-fat (1%) milk
- Nonfat or low-fat yogurt, sour cream, buttermilk
- Cottage cheese, low-fat cheeses
Meat and beans
- Whole milk
- Reduced-fat (2%) milk
- Malted and chocolate milk
- Most cheeses
- Lean cuts of beef, pork, veal, or lamb (look for the word loin or round; trim visible fat before cooking
- Poultry without the skin
- Fish and most shellfish; limit your intake of shrimp
- Egg whites and egg substitutes; limit whole eggs to two per week
- Seeds, nuts; peanut butter should be eaten in moderation due to high calorie content
- Dried peas, beans, and lentils
Fats and oil
- Fatty cuts of meat
- Organ meats like brain, liver, and kidneys
- Poultry skin
- Breaded fish or meats
- More than two egg yolks per week, including those found in baked goods, cooked foods, or processed foods
- Vegetable oils high in unsaturated fat like olive, canola, corn, safflower, or soybean
fat-free soft or liquid margarines; the first ingredient should be unsaturated liquid vegetable oil
- Stanol/sterol-containing margarine
- Low-fat salad dressings and mayonnaise
Snacks, sweets, and condiments
- Butter, stick margarine, coconut and palm oils, bacon fat
- Salad dressings made with egg yolk
- In moderation: Fat-free or low-fat cookies, ice cream, frozen yogurt; sherbet; angel food cake; baked goods made with unsaturated oil or trans-free margarine, egg whites or egg substitutes, and nonfat milk; jello; candy made with little or no fat like hard candy or jelly beans
- High-fat desserts; baked goods made with butter, lard, shortening, egg yolks, or whole milk
- Make whole grains, fruits, and vegetables the base of your diet.
Look for products that are labeled as fat free, low-fat, cholesterol free, saturated fat free and
fat free. However, a product can claim no grams trans fat, even on the label, but still have a small amount. Be sure to look for partially hydrogenated oil. If a product has this, avoid it.
- Become familiar with the Nutrition Facts panel, which lists information, such as the amount of calories, saturated fat, trans fat, and cholesterol per serving of the item.
- Eat foods rich in
omega-3 fatty acids. These include fatty fish such as salmon, mackerel, and tuna; flaxseed; walnuts; canola oil.
Eating fish at least 2 times a week is more effective than omega-3 fatty acid supplements. In fact, evidence about the benefits of supplements is not conclusive.
- Prepare foods by using low-fat methods, such as steaming, boiling, grilling, poaching, baking, broiling, or roasting. If you are sautéing or stir frying, use a cooking spray or small amount of vegetable oil.
- Trim any visible fat off meat or poultry before cooking. Drain the fat after browning.
- Limit high-fat sauces. Add zest to foods by topping them with low-fat items such as fresh herbs, salsas, or chutneys.
- Increase fiber by adding fruit to your cereal or yogurt, beans to your salad, and choosing whole grain breads.
- Cook at home more often. Restaurant food tends to be high in fat and calories.
- Engage in at least 30 minutes of physical activity every day.
- If you are overweight, talk with your doctor about the best methods to lose weight.
- Talk to a registered dietitian for individualized diet advice.
Academy of Nutrition and Dietetics
National Heart, Lung, and Blood Institute
Heart and Stroke Foundation of Canada
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Hypercholesterolemia. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed/what.php. Updated Augsut 20, 2013. Accessed August 27, 2013.
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 August 27, 2013.
What your cholesterol levels mean. American Heart Association website. Available at:
. Updated August 8, 2013. Accessed August 27, 2013.
Last Reviewed August 2013