Foods to Lower Cholesterol

Having elevated LDL cholesterol levels and triglycerides has been associated with an increased risk of heart disease and stroke.  “If you have too much cholesterol, your internal machinery is not going to be able to take away enough cholesterol from the cells,” says Yeon-Kyun Shin, a biophysics professor in the department of biochemistry at Iowa State. “Then cells harden and you can get these deposits.”  But our bodies also need cholesterol for many important functions, such as building cells, manufacturing hormones; and with one quarter of the body’s cholesterol in the brain, it is important for brain activity.  Rather than just lowering overall cholesterol, ideally we want to optimize our ratio of LDL to HDL:

  • Lower LDL: Low-density lipoprotein (LDL) is associated with clogging our arteries and therefore an increased risk of heart disease.  Some experts have even broken down LDL into 2 more categories – the larger less damaging “fluffy” LDL particles, and the smaller more dense particles that are likely to oxidize and cause damage to the arteries. According to the National Cholesterol Education Program, optimal levels of LDL are below 100, near optimal levels are between 100-129, borderline is 130-159, between 160-189 is high, and above 190 is very high.
  • Raise HDL: High density lipoprotein (HDL) is known as the “good” cholesterol, which helps to usher out LDL or bad cholesterol from the bloodstream.  High HDL (over 60 mg/dL)  is associated with lower heart disease risk.  HDL levels below 40 mg/dL are linked to a higher heart disease risk.

Taking a Foods Based Approach to Lower Cholesterol

Foods and other lifestyle factors can have a powerful impact on our health. According to Dr. Schrott from the University of Iowa, “Although medication is a very effective way to treat high cholesterol, diet and weight loss may be the only things you need to do to lower your cholesterol.”  Prescription medications can come with multiple negative side effects and drug interactions, and can be expensive.  Taking a nutritional approach to lowering cholesterol can offer multiple additional benefits such as anti-aging, lowering risks of many other diseases, improved digestion, energy, and more. And taking a foods based approach is also less likely than prescriptions to lower cholesterol levels too low.  The challenges associated with a nutritional approach, are that people first need to know which foods will help lower cholesterol, and unfortunately it is not as easy as popping a pill each day.

Foods that Lower Cholesterol:

1. Soluble Fiber:  Fiber is very important for our digestion, it helps us to feel fuller, which can be useful to maintain a healthy weight – which is very important for overall heart health.  There are two types of fiber – insoluble (which passes through the digestive system intact and provides bulk), and soluble fiber, which soaks up liquid to create a gel-like substance.  It is soluble fiber which is important for lowering cholesterol.  It sticks to cholesterol binding it and ushering it out of the body before it can enter into circulation, which is perhaps why it is sometimes referred to as “sticky fiber.”  According to Dr. Cho from the Cleveland Clinic, a person must consume at least 3 grams of soluble fiber per day in order for it to help to lower cholesterol.  A study published in the Journal of Family Practice in 2006 found that eating 5 – 10 grams of soluble fiber a day was associated with a 10% to 15% reduction in LDL levels, and a 10-15% lower heart disease risk.  Unfortunately most Americans do not get anywhere near that amount of soluble fiber each day, found in fruits and vegetables, legumes, and whole grains.

Soluble Fiber Sources:

  • Oats/oatmeal (1/2 cup = 2 grams)
  • Legumes – (1/2 cup of black beans – 2.4 grams)
  • Fruits & vegetables – especially eggplant, okra, grapes, apples (1.0 grams), and oranges (1.7 grams)
  • Psyllium (70% soluble fiber) Read about psyllium for lowering cholesterol: American Journal of Clinical Nutrition Study.
  • Chia seeds – a highly nutritious and hydrophillic food – soaking up about 10 times it’s weight in water.  Read more.

2. Omega 3s:   For years, people with heart disease were put on strict low fat diets.  But certain fats, particularly omega 3 fatty acids, are very important for our heart health and are shown to lower cholesterol levels. Found in foods like fatty fish, omega 3s are extremely important to our overall health – affecting everything from our brain functioning and our mood to disease prevention and eye health. Omega 3 fatty acids have been shown to lower our risk of many diseases – including heart disease and cancer.  The Inuit Eskimos get lots of omega 3 fatty acids from their diets which are high in fatty fish, they also tend to have healthy HDL levels and lower triglycerides. The American Heart Association recommends eating fish (particularly fatty fish such as mackerel, lake trout, herring, sardines, albacore tuna, and salmon) at least 2 times a week.

Some omega 3 sources:

  • Fatty fish – salmon, sardines, tuna, herring, mackerel
  • Fish oils
  • Chia/flax seeds

3. Antioxidants: Powerful botanical antioxidants such as Polyphenols and Flavinoids can offer protection against free radical exposure and offer a wide range of health benefits from anti-aging and boosting the skin’s SPF protection to reducing cancer risk and Alzheimer’s protection.  Polyphenols have been shown in some studies to lower cholesterol by increasing the amount of cholesterol excreted by the body as well as boosting levels of HDL (good) cholesterol. Flavinoids such as those found in cocoa have been shown to reduce the oxidation of LDL cholesterol, so have a square of chocolate without guilt!  And then pour yourself a some tea – drinking three cups of green or black tea a day has been shown in studies to improve cholesterol ratios and lower heart attack risk.  Coffee and even red wine (in moderation) can offer beneficial antioxidants.

Some good sources:

  • Cacao/Dark chocolate – 1 oz.  Read more about dark chocolate’s health benefits.
  • Teas – green, black, oolong, etc.
  • Coffee
  • Grapes and other fruit
  • Red wine (in moderation)

4. Plant Sterols.  Over 140 clinical studies show that plant sterols can help reduce LDL blood cholesterol.  Plant sterols occur naturally in plant-based foods, but generally in concentrations that are too low to affect blood cholesterol levels.  But when plant sterols are extracted, they can be concentrated and added to fortify other foods.  Sterols are basically plant cholesterol, which in the human body competes with and prevents the uptake and absorption of cholesterol in the small  intestine.  Sterols are shown to improve the important LDL to HDL ratios, because they lower LDL cholesterol, without affecting the HDL (the good kind).  Plant sterols have been studied for over 50 years, and found to be a safe and effective way to lower cholesterol.  The American Heart Association’s (AHA) recommends that individuals with high cholesterol consume plant sterols and plant stanols from a variety of foods and beverages every day—just as they would use cholesterol-lowering medication to maintain LDL (bad) cholesterol reductions from these products. Studies have found that 1.3 g. of plant sterols can have significant cholesterol lowering effects.  The AHA recommends patients with high cholesterol consume approximately 2 grams of plant sterol/stanols per day.  The average American gets about 250 milligrams (.25 g.) of sterols from plant-based foods daily. Vegetarians average around 700 milligrams.  But people who eat a highly processed diet can get significantly less.

Plant Sterol Sources:

  • Peanuts (.1 g)
  • Sesame Seeds (.1 g)
  • Foods fortified with plant sterols such as Corazonas Tortilla Chips  (.5 g/serving) & Oatmeal Squares (.8 g/serving)

5. Nuts and other plant-based fats:  Nuts are little nutritional powerhouses, containing protein, fiber, healthy fats, and many other excellent nutrients. Nuts are so good for you that in 2003 the FDA made this claim: “Eating a diet that includes one ounce of nuts daily can reduce your risk of heart disease.”  One 2004 study of 58 adults with diabetes looked at the effects of eating a handful of walnuts each day in addition to a healthy diet. The researchers found that on average, people who ate the walnuts had an increase in their good HDL cholesterol and a drop of 10% in their bad LDL cholesterol levels. The results were published in the publication Diabetes Care.

Healthy Fats Sources:

  • Nuts
  • Avocados
  • Olives
  • Grapeseed oil contains a natural chemical that may help reduce levels of LDL. Check with your doctor if you are taking prescription medications (especially blood thinners) before consuming grapeseed oil.
  • Chia/flax seeds

Foods to Avoid:

It is also important to know which foods to avoid to promote healthy cholesterol levels and heart health.  Many people have been told for years that eggs are bad for our cholesterol.  But new research is showing that for the majority of the population, eating an egg a day will not raise blood cholesterol and is a healthy choice.  According to Harvard Health, the biggest influence on blood cholesterol level is the mix of fats and carbohydrates in your diet—not the amount of cholesterol you eat from food. So more important than avoiding foods with cholesterol in them, is avoiding foods that contain trans fats, which can be found in many packaged, processed, baked goods, most margarines, and fast foods.  Another surprising food to avoid for cholesterol and heart health is sugar. A recent study published in the Journal of the American Medical Association revealed that added sugars found in packaged foods increased blood lipid levels while lowering the good cholesterol (HDL) levels.

What About Statins?

Statins lower cholesterol by inhibiting HMG CoA reductase, an enzyme that helps the body make cholesterol, which reduces the total cholesterol in the blood according to Dr. Mark Houston, MD.  In the past, statins success at preventing heart attacks, had led doctors to joke about “putting it into the water supply,” according to this USA Today Article.  But increasing research is revealing that raising the HDL cholesterol, which is responsible for removing cholesterol from the blood and delivering it to the liver for removal is as important as lowering LDL for heart health.  According to Dr. Mark Hyman, MD, a 2009 study looked at nearly a quarter of a million people who were hospitalized with heart disease, almost half of those people had optimal LDL levels.  Additionally, some studies have linked Statin use to side effects, including:

Adopting healthy dietary and lifestyle habits can help to lower your cholesterol, your overall heart attack risk factors, and many other diseases.  But despite making all the above dietary and lifestyle changes, some people (such as those who have already had a heart attack) might still need a statin.  Patients need to speak to their doctor to assess and develop their personal heart health plan.  But according Dr. Mark Hyman, “You can not take your statin, and then go to McDonald’s and expect it to work.” Dr. Hyman, the founder of The Ultra Wellness Center in Lenox, MA; also says that when it comes to cholesterol medication, men and women are not created equal – read his article Why Women Should Stop Their Cholesterol Lowering Medication.

Note: Persons currently taking cholesterol lowering medications who have questions, or wish to stop taking them (or any prescription medications) should consult with their doctor.  Changes to prescription medications should be done only under their doctor’s care.

Other Heart Health Factors:

Cholesterol is only one piece of the puzzle with regards to heart health. Other important factors to consider are:

  • C-reactive protein (inflammation marker – under 1 is optimal, between 1-3 means average risk)
  • Triglycerides (blood fats, under 1oo md/dL is optimal)
  • Blood pressure (normal is 120/80 or under, learn more)
  • Blood sugar – eating too much sugar is associated with elevated triglycerides and cholesterol in the blood, read more.
  • Overall weight & Abdominal/visceral fat – deep abdominal fat is linked to a higher heart disease risk, read more.  Just losing weight lowers heart disease risk.
  • Exercise
  • Stress levels

Additional Supporting Articles/Research:

  • http://www.scientificamerican.com/article.cfm?id=its-not-dementia-its-your-heart-medication
  • http://www.medicalnewstoday.com/releases/140127.php
  • http://articles.latimes.com/2010/apr/05/health/la-he-nutrition-20100405
  • http://www.health.harvard.edu/press_releases/egg-nutrition
  • http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/fats-and-cholesterol/
  • http://www.webmd.com/cholesterol-management/9-surprising-foods-that-may-raise-your-cholesterol
  • http://yourlife.usatoday.com/health/medical/diabetes/story/2012-01-09/Study-links-statins-to-higher-diabetes-in-older-women/52470838/1
  • http://www.ncbi.nlm.nih.gov/pubmed/17560286
  • http://heartdisease.about.com/lw/Health-Medicine/Conditions-and-diseases/Plant-Sterols-in-Food-Products.htm

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*This article is for educational purposes only.  The content contained in this article is not to be construed as providing medical advice. All information provided is general and not specific to individuals. Persons experiencing problems or with questions about their health or medications, should consult their medical professional. Persons already taking prescription medications should consult a doctor before taking the above foods, herbs, vitamins or supplements to be sure there are no interactions.  Persons wishing to cease taking prescription medications should do so only after consulting with their doctor.

Sara Vance is a Clinical Nutritionist in the Encinitas, CA area.

Sara offers nutritional counseling, School Assemblies, group classes, kids healthy cooking, and more. Visit ReBalanceLife.com for more information.  Friend Sara Vance at ReBalance Life on Facebook.

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