High cholesterol is one of the top risk factors for cardiovascular disease. A sedentary lifestyle, smoking, alcohol and poor eating habits can all contribute to elevated cholesterol. But what are the best foods to eat for high cholesterol?May 10, 2022 5:46 pm May 10, 2022 5:46 pm
What is cholesterol?
Cholesterol is a substance found in your blood. Our liver naturally produces cholesterol and all humans have it in their bodies. Moreover, we need cholesterol because our body’s cells use it to perform various functions. In part, cholesterol comes from our diet. When someone has high cholesterol, this means there are above normal levels of these substances circulating in the bloodstream. This is cause for concern and calls for intervention. In fact, having high cholesterol can increase your risk of heart disease including risk of heart attacks and strokes.
The good and the bad
There is an important difference between types of cholesterol. In fact, most of us have heard about “good” and “bad cholesterol”. It is too much of the “bad” cholesterol which can lead to health problems. The two main types of cholesterol are HDL and LDL, these stand for High-density lipoproteins and Low-density lipoproteins respectively. Lipoproteins refer to compounds made up of cholesterol and proteins. In fact, proteins carry cholesterol around the blood , thus the “coupling” of cholesterol and protein is called lipoprotein.
High-density lipoproteins (HDL) is colloquially called “good” cholesterol. HDL’s role is to remove the “bad” cholesterol from your blood. In fact, it transports any cholesterol that your body doesn’t need back to your liver. Consequently, the liver breaks down this cholesterol which is then excreted from your body.
Conversely, Low-density lipoproteins (LDL) is often referred to as ‘bad’ cholesterol. Excess amounts of LDL can build up inside artery walls and clog them. This build up causes arteries to narrow thus increasing the risk of a cardiovascular event.The buildup of cholesterol inside artery walls is called atherosclerosis.
If your total cholesterol levels are high, this means you have high levels of “bad” cholesterol in your blood. On the other hand, high levels of HDL (“good”) cholesterol can regulate “bad” cholesterol” and remove it from your system.(1)
“Oats contain a special type of fibre called beta-glucan which binds to cholesterol [...] daily oat consumption can reduce total and bad cholesterol by up to 10%.”
Modifiable vs non-modifiable risk factors
There are various causes of high cholesterol and these can differ between individuals. Unfortunately some risk factors are out of our control, but fortunately others are very much modifiable. Focusing on the risk factors within our control is the best thing you can do to lower your risk of developing high cholesterol or decreasing your cholesterol if your levels are already high.
Focusing on what you can control…
The main modifiable risk factors are: eating too much saturated fat, leading a sedentary lifestyle and not getting enough exercise, and having excess body fat, especially around the waistline. Smoking is also a major modifiable risk factor that can cause high cholesterol. In fact, the build up of tar in the arteries can facilitate cholesterol sticking to artery walls. Overweight and diabetes can also increase the likelihood of developing high cholesterol.
…and being aware of what you can’t
Conversely, there are non-modifiable risk factors for high cholesterol, these include: ageing, ethnic background, gender, kidney and liver disease, an underactive thyroid, and familial hypercholesterolaemia (a genetic, inherited form of high cholesterol that some people are born with).
What is the Portfolio diet?
Fortunately there are a few ways that you can actively lower your cholesterol, these include exercising, quitting smoking if you currently smoke, and eating a healthy balanced diet, low in saturated fat. Let’s focus on the nutrition factor and discuss which foods can assist with high cholesterol.
Modifying your diet can lower your cholesterol levels. In particular, eating foods that lower the LDL cholesterol which contributes to atherosclerosis is one of the best strategies to fight high cholesterol.
By now you’ve probably heard about the Mediterranean Diet and perhaps also the DASH diet, which was specifically designed to lower blood pressure. However you may not have heard about the Portfolio diet.
These three eating patterns share a common characteristic: they are heavily plant-based and heart health is the main priority. However, the Portfolio diet is also specifically aimed at lowering cholesterol. In fact, evidence has shown that the Portfolio diet can be more effective than a low saturated fat diet at lowering cholesterol. In fact, people who follow the Portfolio diet in addition to having low intakes of saturated fats can lower their “bad” cholesterol by up to 35%.(2)
So what exactly constitutes the Portfolio Diet? Overall the diet encompasses several key pillars proven to decrease cholesterol. The foundation of the diet is made up of fruits, vegetables and whole grains. In addition, there are four specific foods which target cholesterol, these are: nuts/healthy fats, soy protein, foods containing soluble fibre and foods containing plant sterols.
Spotlight on soluble fibre
Soluble fibre is found in many plant foods including beans, pears, apples, eggplant, barley and oats. In fact, oats have gained substantial attention regarding their ability to reduce cholesterol. Oats contain a special type of fibre called beta-glucans which bind to cholesterol and help the body to excrete it. So daily oat consumption can significantly reduce bad cholesterol. Research shows that if taken daily at doses of at least 3g, beta-glucans may reduce total and bad cholesterol by up to 10%.(3) Now that’s one more reason to have a bowl of oatmeal for breakfast!
The power of plant sterols
Plant foods naturally contain plant sterols and stanols. These are also called phytosterols, which are cholesterol-like compounds. These include vegetable oils, breads and cereals, nuts, seeds, legumes, fruit and vegetables.
They play an important role in reducing LDL cholesterol in the blood. In fact, their similar structure to cholesterol means that they reduce the absorption of cholesterol in the gut so that more of it is excreted through faeces. Consuming 2 grams of plant sterols or stanols per day can decrease LDL cholesterol by up to 10%.(4)
Certain products such as some milks and margarines are fortified with added plant sterols. These foods may be beneficial for people with high cholesterol, children with familial hypercholesterolaemia and people taking statins. Always check with your doctor or dietitian before you start taking fortified products to ensure they are appropriate for your individual condition.(5)
Saturated fats have also been linked to increased cholesterol levels and poor heart health. These types of fats are mainly found in animal products (for example butter) but also in some plant foods such as coconut oil. To ensure healthy cholesterol levels, it is best to replace saturated fats with unsaturated fats. In particular, replacing saturated fats with monounsaturated fats and polyunsaturated fats can help to reduce bad cholesterol.
Some of the best sources of monounsaturated fats include extra virgin olive oil and almond oil. In fact, extra virgin olive oil consumption is linked to a reduction in LDL cholesterol, and reduced risk of cardiovascular disease and mortality.(6)
The power of nuts
Moreover, nuts are an excellent source of healthy fats which have been shown to reduce cholesterol. They also contain fibre which can mitigate some of the bad cholesterol from being absorbed into the bloodstream from the gut. Clinical studies have consistently shown that nuts lower total and LDL cholesterol.
In fact, it is believed that the favourable fatty acid profile of nuts (i.e. low saturated fats and high unsaturated fats) lowers cholesterol thus also reducing the risk of coronary heart disease. A summary of studies found that nuts can reduce LDL cholesterol by up to 19% compared to Western and lower-fat diets. The plant sterols and antioxidants naturally found in nuts may also favourably impact cholesterol.
Overall, nuts have a unique nutrient profile and can be part of a healthy diet including many heart-friendly foods. Moreover, it appears that diets including nuts may have stronger cholesterol-lowering effects than general diets used to lower cardiovascular risk which do not include nuts.(7) One handful a day is enough, you can have them as a snack or add them to salads, yoghurt or porridge. Choose the raw unsalted varieties for the best nutritional profile.(8)
Soybeans and derived foods are great additions to a heart-friendly diet. In fact, soybeans are low in saturated fat and high in dietary fibre, both essential prerequisites for a cholesterol-lowering diet. Moreover, soy products are great alternatives to their high saturated fat counterparts such as fatty meat and full fat dairy. Research shows that consuming 25 grams of soy protein a day (10 ounces of tofu or 2 1/2 cups of soy milk) can lower LDL by 5% to 6%.(4) Many products such as soy milk, tofu, soy nuts and soy cheese contain soy protein. If you are new to soy products, you can try substituting regular milk with soy milk in your porridge or daily coffee. You can also use tofu as a meat alternative in stir fries with some vegetables and rice.
In 2019, a group of researchers carried out a meta-analysis to determine the effect of soy on serum cholesterol levels. They analysed 46 randomised controlled trials and found that soy consumption is associated with a small but significant reduction in total and LDL cholesterol levels.
In conclusion, it appears that several foods and nutrients may be particularly beneficial in lowering cholesterol. In fact, the Portfolio diet encompasses the key foods shown to significantly reduce serum cholesterol levels. Try including some oats, nuts, healthy oils, plant sterols and soy protein into your diet to see the results for yourself.
*Note: It is not recommended to consume foods fortified with plant sterols unless you have been diagnosed with high cholesterol by your doctor and they have advised that it is ok for you to consume these products.
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