Understanding cholesterol is crucial for managing heart health. Cholesterol is a fatty substance found in your blood that’s necessary for building cells and producing hormones. However, imbalances in cholesterol levels can increase the risk of heart disease and stroke.

In this article, we’ll explore what foods to eat, what foods to avoid, and other dietary and lifestyle changes to control your cholesterol levels. Keep reading to find out how these adjustments can significantly impact your heart health and overall well-being.

Cholesterol is a waxy, fat-like substance present in every cell of your body. It’s essential for producing hormones, vitamin D, and bile acids that help digest fat.

Cholesterol travels through your bloodstream in two main forms: LDL (low-density lipoprotein) and HDL (high-density lipoprotein). Maintaining a balance between these types is key to good health.

Cholesterol is often linked to cardiovascular diseases (CVD). This is because high cholesterol levels can lead to plaque formation in the arteries, narrowing the arteries and causing atherosclerosis. This condition increases the risk of heart diseases and heart attacks.

However, some studies have not found conclusive evidence that dietary cholesterol increases risk of CVD [1]. Instead, researchers have observed that foods high in cholesterol are high in saturated fatty acids as well, which are more clearly associated with heart problems.

Therefore, it’s important to remember that there are various factors involved in heart disease such as dietary components, inflammation, oxidative stress, high blood pressure, and smoking.

Cholesterol is divided into two types, which are:

• Low-Density Lipoprotein (LDL): Often referred to as “bad” cholesterol, LDL can build up in the walls of your arteries, leading to plaque formation and increasing the risk of heart disease and stroke. High levels of LDL are a major risk factor for cardiovascular problems.
• High-Density Lipoprotein (HDL): Known as “good” cholesterol, HDL helps remove LDL cholesterol from the arteries and carries it to the liver for elimination. Higher levels of HDL are associated with a lower risk of heart disease.

Cholesterol levels are measured through a blood test called a lipid panel. This test assesses the levels of total cholesterol, LDL, HDL, and triglycerides. Regular testing helps monitor and manage cholesterol levels effectively, guiding necessary lifestyle or medication changes.

What Foods to Eat

We recommend including the following foods in your diet:

1. Whole Grains

Whole grains like barley, oats, beans, and lentils are high in soluble fibre. Soluble fibre helps reduce levels of LDL (low-density lipoprotein) cholesterol, often referred to as “bad” cholesterol [2]. By incorporating these whole grains into your diet, you can effectively lower your cholesterol levels and improve overall heart health.

2. Fruits and Vegetables

Vegetables from the lettuce family such as coral lettuce, watercress, romaine lettuce, butterhead lettuce, and iceberg lettuce; and fruits such as apples, pears, figs, and apricots are rich in antioxidants, vitamin C, polyphenols, vitamin E, carotenoids, and soluble fibre [3].

Their fibre content helps lower LDL cholesterol levels, while their antioxidant properties protect against inflammation and oxidative stress, supporting heart health [4].

3. Dark Chocolate and Cocoa

Consuming dark chocolate and cocoa in moderation can be beneficial to heart health. Dark chocolate and cocoa, which are rich in flavonoids, have been found to reduce blood sugar levels, blood pressure levels, and LDL cholesterol concentration [5].

Research has even highlighted the potential of dark chocolate in reducing complications faced by diabetic patients [6]. However, further studies are needed to fully understand the effectiveness of dark chocolate and cocoa intake.

4. Healthy Oils

Healthy oils like olive oil, mustard oil, and flaxseed oil, are cholesterol and trans fat free, low in saturated fats, but high in monounsaturated fats (MUFA) and polyunsaturated fats (PUFA). This can help lower LDL cholesterol and increase HDL cholesterol levels. Thus, substituting butter and lard with these oils provide heart-healthy fats that contribute to a balanced diet and overall cardiovascular wellness.

5. Omega-3 Fatty Acids

Omega-3 fatty acids have been shown to lower triglycerides, a type of fat in the blood that can contribute to heart disease. While some studies suggest omega-3s may also reduce LDL cholesterol levels, their overall effect on cholesterol remains controversial among researchers.

Oily fish such as salmon, mackerel, and sardines are excellent sources of omega-3s. Seeds from the Brassica family, such as mustard, canola, and turnip are also rich in omega-3s.

6. Lean Meat

Lean meat such as skinless chicken and turkey breast is low in saturated and trans fat, and therefore does not raise total cholesterol and LDL cholesterol levels. Lean red meat, such as lean cuts of pork and beef that has been trimmed of visible fat is also cholesterol-friendly [7]. Ultimately, choosing lean meats supports healthier cholesterol levels and cardiovascular health.

7. Legumes

Legumes such as beans, lentils, and chickpeas are rich in soluble fibre and plant-based protein. The soluble fibre in legumes helps lower blood sugar and LDL cholesterol levels, while the protein content makes them a satiating alternative to animal-based protein. Thus, incorporating legumes into your diet can improve cholesterol levels and support heart health.

8. Nuts

Nuts such as almonds, walnuts, pecans, peanuts, and hazelnuts are rich in unsaturated fats, fibre, vitamin E and C, folic acid, and other nutrients that can help significantly lower total cholesterol and LDL cholesterol levels [8]. Researchers concluded that consuming a small portion of nuts (around 50 to 100g) as part of a heart healthy diet at least five times a week can support heart health [9].

9. Soy

Soy products, including tofu, tempeh, and edamame, are rich in components such as protein, phytic acid, saponins, and fibre which help to lower total cholesterol and LDL cholesterol levels. Thus, incorporating soy into your diet can be a heart-healthy alternative to animal-based proteins and support overall cholesterol management [10].

10. Plant Sterols and Stanols

Sterols and stanols can reduce absorption of cholesterol in the body, lowering the total cholesterol and non-HDL cholesterol in the blood [11]. Stanols and sterols are found in fruits and vegetables, cereals, legumes, nuts, seeds, and dairy products fortified with stanols and sterols. Do get your nutrients from these whole foods, rather than sterol and stanol supplements.

Need help in planning a low cholesterol diet? Schedule an appointment with our experienced doctors and dietitians at Island Hospital. We’ll provide personalised advice tailored to your health needs.

For comprehensive cardiac care, trust our Cardiology Department and Heart Centre. Our skilled specialists offer advanced diagnosis and treatments for a wide range of heart conditions. Book your consultation now and take the first step towards a healthier you.

What is the Best Diet to Reduce Cholesterol?

To lower cholesterol levels and achieve optimal heart health, experts recommend the Mediterranean, DASH, and healthy plant-based diets [12]. These diets consist mostly of fruits, vegetables, legumes, nuts, and whole grains, and limit intake of meat products and processed foods. If you’re interested in starting one of these diets, consult your doctor or dietitian.

On the other hand, experts recommend avoiding controversial diets such as the ketogenic diet. This diet, which consists of a low carbohydrate, high fat, and moderate protein intake, has been found to increase total cholesterol, LDL cholesterol levels, non-HDL cholesterol, and total apolipoprotein B (apoB) – increasing the risk of heart disease.

Searching for a diet that supports heart health? Read our article on simple tips for a heart-healthy diet.

What Foods to Avoid

We recommend reducing intake of the following foods:

• Processed Foods: High in unhealthy fats, sugars, and sodium, which can raise LDL cholesterol and triglycerides.
• Fried Foods: Often cooked in oils high in saturated and trans fats, increasing LDL cholesterol and lowering HDL cholesterol.
• Fast Foods: Typically high in unhealthy fats, calories, and sodium, contributing to higher cholesterol and weight gain.
• High-Sodium Foods: Can raise blood pressure and exacerbate cholesterol problems; examples include canned soups and salty snacks.

Dietary and Lifestyle Tips to Control Cholesterol

Practise the following habits to keep your cholesterol levels low:

1. Use Spice and Herbs to Flavour Food (Limit Salt)
Spices and herbs like garlic, turmeric, and basil can enhance the flavour of your meals without adding extra sodium. Excessive salt intake is linked to high blood pressure, which can exacerbate cholesterol issues. Opting for natural flavourings helps reduce your sodium intake and can contribute to better cardiovascular health.

2. Exercise Regularly
Regular physical activity helps raise HDL cholesterol while lowering LDL cholesterol and triglycerides. Aim for at least 150 minutes of moderate aerobic exercise or 75 minutes of vigorous exercise per week, along with muscle-strengthening activities. Activities like walking, swimming, and cycling can improve your heart health and assist in managing weight.

3. Maintain a Healthy Plate
Focus on a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Incorporate foods high in soluble fibre, such as oats and beans, which help reduce LDL cholesterol. Moderation is key – watch portion sizes and limit intake of saturated and trans fats found in processed foods and fatty cuts of meat.

4. Maintain a Healthy Body Weight
Excess body weight can raise LDL cholesterol and lower HDL cholesterol. Losing even a small amount of weight can positively impact your cholesterol levels and overall health. Combining a balanced diet with regular exercise is the most effective way to achieve and maintain a healthy weight.

5. Quit Smoking and Alcohol Drinking
Smoking increases total cholesterol, LDL cholesterol, and triglyceride levels [13]. Quitting smoking can improve your cholesterol levels and reduce your risk of heart disease. Excessive alcohol consumption can also raise cholesterol and triglyceride levels, so limiting alcohol intake to moderate levels is advisable [13].

6. Adapt to Healthier Cooking Styles (Using Minimal Fats)
Use cooking methods that require less fat, such as baking, steaming, grilling, or sautéing with minimal oil. Use heart-healthy oils like olive oil or canola oil in moderation. Reducing the amount of added fats can help lower saturated fat intake, which is beneficial for maintaining healthy cholesterol levels.

7. Schedule Regular Health Checkups
Regular checkups with your healthcare provider help monitor cholesterol levels and assess cardiovascular risk. Your doctor can offer personalised advice based on your cholesterol profile, overall health, and family history. Regular health screenings are crucial for catching and addressing any issues early.

Plan Your Low Cholesterol Diet With Island Hospital